Individual
KENNETH BRYAN BEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
112 JEFFERSON ST, WEST UNION, IA 52175-1022
(563) 422-9738
Mailing address
13646 240TH ST, WEST UNION, IA 52175-9419
(563) 422-5386
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D-119341
IA
Other
Enumeration date
05/08/2006
Last updated
01/25/2010
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